480 research outputs found
What is the Future of Preprint Peer Review?
N/a.</jats:p
Supersymmetric solutions of PT-/non-PT-symmetric and non-Hermitian Screened Coulomb potential via Hamiltonian hierarchy inspired variational method
The supersymmetric solutions of PT-symmetric and Hermitian/non-Hermitian
forms of quantum systems are obtained by solving the Schrodinger equation for
the Exponential-Cosine Screened Coulomb potential. The Hamiltonian hierarchy
inspired variational method is used to obtain the approximate energy
eigenvalues and corresponding wave functions.Comment: 13 page
On R\'enyi and Tsallis entropies and divergences for exponential families
Many common probability distributions in statistics like the Gaussian,
multinomial, Beta or Gamma distributions can be studied under the unified
framework of exponential families. In this paper, we prove that both R\'enyi
and Tsallis divergences of distributions belonging to the same exponential
family admit a generic closed form expression. Furthermore, we show that
R\'enyi and Tsallis entropies can also be calculated in closed-form for
sub-families including the Gaussian or exponential distributions, among others.Comment: 7 page
Association between adherence to calcium-channel blocker and statin medications and likelihood of cardiovascular events among US managed care enrollees
<p>Abstract</p> <p>Background</p> <p>Prior studies have found that patients taking single-pill amlodipine/atorvastatin (SPAA) have greater likelihood of adherence at 6 months than those taking 2-pill calcium-channel blocker and statin combinations (CCB/statin). This study examines whether this adherence benefit results in fewer cardiovascular (CV) events.</p> <p>Methods</p> <p>A retrospective cohort study was conducted using administrative claims data from the IMS LifeLink: US Health Plan Claims database, identifying adults already taking CCB or statin (but not both) who had an index event of either initiating treatment with SPAA or adding CCB to statin (or vice versa) between April 1, 2004 to August 31, 2005. Inclusion criteria included age 18+ years, continuously enrolled for minimum of 6 months prior and 18 months following treatment initiation, >1 diagnosis of hypertension, and no prescription claims for SPAA or added CCB or statin for 6 months prior. Exclusion criteria included >1 claim with missing or invalid days supplied, age 65+ years and not enrolled in Medicare Advantage, or history of prior CV events, cancer diagnosis, or chronic renal failure. The primary outcome measure was the rate of CV events (myocardial infarction, heart failure, angina, other ischemic heart disease, stroke, peripheral vascular disease, or revascularization procedure) from 6 to 18 months following index date, analyzed at three levels: 1) all adherent vs. non-adherent patients, 2) SPAA vs. dual-pill patients (regardless of adherence level), and 3) adherent SPAA, adherent dual-pill, and non-adherent SPAA patients vs. non-adherent dual-pill patients.</p> <p>Results</p> <p>Of 1,537 SPAA patients, 56.5% were adherent at 6 months, compared with 21.4% of the 17,910 CCB/statin patients (p < 0.001). Logistic regression found SPAA patients more likely to be adherent (OR = 4.7, p < 0.001) than CCB/statin patients. In Cox proportional hazards models, being adherent to either regimen was associated with significantly lower risk of CV event (HR = 0.77, p = 0.003). A similar effect was seen for SPAA vs. CCB/statin patients (HR = 0.68, p = 0.02). In a combined model, the risk of CV events was significantly lower for adherent CCB/statin patients (HR = 0.79, p = 0.01) and adherent SPAA patients (HR = 0.61, p = 0.03) compared to non-adherent CCB/statin patients.</p> <p>Conclusions</p> <p>Patients receiving SPAA rather than a 2-pill CCB/statin regimen are more likely to be adherent. In turn, adherence to CCB and statin medications is associated with lower risk of CV events in primary prevention patients.</p
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Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44495/1/10745_2005_Article_BF01880261.pd
Pancreatic cancer: Surgery is a feasible therapeutic option for elderly patients
<p>Abstract</p> <p>Background</p> <p>Compromised physiological reserve, comorbidities, and the natural history of pancreatic cancer may deny pancreatic resection from elderly patients. We evaluated outcomes of elderly patients amenable to pancreatic surgery.</p> <p>Methods</p> <p>The medical records of all patients who underwent pancreatic resection at our institution (1995-2007) were retrospectively reviewed. Patient, tumor, and outcomes characteristics in elderly patients aged ≥ 70 years were compared to a younger cohort (<70y).</p> <p>Results</p> <p>Of 460 patients who had surgery for pancreatic neoplasm, 166 (36%) aged ≥ 70y. Compared to patients < 70y (n = 294), elderly patients had more associated comorbidities; 72% vs. 43% (p = 0.01) and a higher rate of malignant pathologies; 73% vs. 59% (p = 0.002). Operative time and blood products consumption were comparable; however, elderly patients had more post-operative complications (41% vs. 29%; p = 0.01), longer hospital stay (26.2 vs. 19.7 days; p < 0.0001), and a higher incidence of peri-operative mortality (5.4% vs. 1.4%; p = 0.01). Multivariable analysis identified age ≥ 70y as an independent predictor of shorter disease-specific survival (DSS) among patients who had surgery for pancreatic adenocarcinoma (n = 224). Median DSS for patients aged ≥ 70y vs. < 70y were 15 months (SE: 1.6) vs. 20 months (SE: 3.4), respectively (p = 0.05). One, two, and 5-Y DSS rates for the cohort of elderly patients were 58%, 36% and 23%, respectively.</p> <p>Conclusions</p> <p>Properly selected elderly patients can undergo pancreatic resection with acceptable post-operative morbidity and mortality rates. Long term survival is achievable even in the presence of adenocarcinoma and therefore surgery should be seriously considered in these patients.</p
Synchronization and Timing in CMS HCAL
The synchronization and timing of the hadron calorimeter (HCAL) for the Compact Muon Solenoid has been extensively studied with test beams at CERN during the period 2003-4, including runs with 40 MHz structured beam. The relative phases of the signals from different calorimeter segments are timed to 1 ns accuracy using a laser and equalized using programmable delay settings in the front-end electronics. The beam was used to verify the timing and to map out the entire range of pulse shapes over the 25 ns interval between beam crossings. These data were used to make detailed measurements of energy-dependent time slewing effects and to tune the electronics for optimal performance
Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials
Background:
Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large statin trials to compare the effects of statin therapy at different ages.
Methods:
In this meta-analysis, randomised trials of statin therapy were eligible if they aimed to recruit at least 1000 participants with a scheduled treatment duration of at least 2 years. We analysed individual participant data from 22 trials (n=134 537) and detailed summary data from one trial (n=12 705) of statin therapy versus control, plus individual participant data from five trials of more intensive versus less intensive statin therapy (n=39 612). We subdivided participants into six age groups (55 years or younger, 56–60 years, 61–65 years, 66–70 years, 71–75 years, and older than 75 years). We estimated effects on major vascular events (ie, major coronary events, strokes, and coronary revascularisations), cause-specific mortality, and cancer incidence as the rate ratio (RR) per 1·0 mmol/L reduction in LDL cholesterol. We compared proportional risk reductions in different age subgroups by use of standard χ2 tests for heterogeneity when there were two groups, or trend when there were more than two groups.
Findings:
14 483 (8%) of 186 854 participants in the 28 trials were older than 75 years at randomisation, and the median follow-up duration was 4·9 years. Overall, statin therapy or a more intensive statin regimen produced a 21% (RR 0·79, 95% CI 0·77–0·81) proportional reduction in major vascular events per 1·0 mmol/L reduction in LDL cholesterol. We observed a significant reduction in major vascular events in all age groups. Although proportional reductions in major vascular events diminished slightly with age, this trend was not statistically significant (ptrend=0·06). Overall, statin or more intensive therapy yielded a 24% (RR 0·76, 95% CI 0·73–0·79) proportional reduction in major coronary events per 1·0 mmol/L reduction in LDL cholesterol, and with increasing age, we observed a trend towards smaller proportional risk reductions in major coronary events (ptrend=0·009). We observed a 25% (RR 0·75, 95% CI 0·73–0·78) proportional reduction in the risk of coronary revascularisation procedures with statin therapy or a more intensive statin regimen per 1·0 mmol/L lower LDL cholesterol, which did not differ significantly across age groups (ptrend=0·6). Similarly, the proportional reductions in stroke of any type (RR 0·84, 95% CI 0·80–0·89) did not differ significantly across age groups (ptrend=0·7). After exclusion of four trials which enrolled only patients with heart failure or undergoing renal dialysis (among whom statin therapy has not been shown to be effective), the trend to smaller proportional risk reductions with increasing age persisted for major coronary events (ptrend=0·01), and remained non-significant for major vascular events (ptrend=0·3). The proportional reduction in major vascular events was similar, irrespective of age, among patients with pre-existing vascular disease (ptrend=0·2), but appeared smaller among older than among younger individuals not known to have vascular disease (ptrend=0·05). We found a 12% (RR 0·88, 95% CI 0·85–0·91) proportional reduction in vascular mortality per 1·0 mmol/L reduction in LDL cholesterol, with a trend towards smaller proportional reductions with older age (ptrend=0·004), but this trend did not persist after exclusion of the heart failure or dialysis trials (ptrend=0·2). Statin therapy had no effect at any age on non-vascular mortality, cancer death, or cancer incidence.
Interpretation:
Statin therapy produces significant reductions in major vascular events irrespective of age, but there is less direct evidence of benefit among patients older than 75 years who do not already have evidence of occlusive vascular disease. This limitation is now being addressed by further trials.
Funding:
Australian National Health and Medical Research Council, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, and British Heart Foundation
Design, Performance and Calibration of the CMS Forward Calorimeter Wedges
We report on the test beam results and calibration methods using charged particles of the CMS Forward Calorimeter (HF). The HF calorimeter covers a large pseudorapidity region (3\l |\eta| \le 5), and is essential for large number of physics channels with missing transverse energy. It is also expected to play a prominent role in the measurement of forward tagging jets in weak boson fusion channels. The HF calorimeter is based on steel absorber with embedded fused-silica-core optical fibers where Cherenkov radiation forms the basis of signal generation. Thus, the detector is essentially sensitive only to the electromagnetic shower core and is highly non-compensating (e/h \approx 5). This feature is also manifest in narrow and relatively short showers compared to similar calorimeters based on ionization. The choice of fused-silica optical fibers as active material is dictated by its exceptional radiation hardness. The electromagnetic energy resolution is dominated by photoelectron statistics and can be expressed in the customary form as a/\sqrt{E} + b. The stochastic term a is 198% and the constant term b is 9%. The hadronic energy resolution is largely determined by the fluctuations in the neutral pion production in showers, and when it is expressed as in the electromagnetic case, a = 280% and b = 11%
Interpretation of the evidence for the efficacy and safety of statin therapy
This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for
the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled
trials yields reliable information about both the effi cacy and safety of statin therapy. In addition, it discusses how
claims that statins commonly cause adverse eff ects refl ect a failure to recognise the limitations of other sources of
evidence about the eff ects of treatment. Large-scale evidence from randomised trials shows that statin therapy reduces
the risk of major vascular events (ie, coronary deaths or myocardial infarctions, strokes, and coronary revascularisation
procedures) by about one-quarter for each mmol/L reduction in LDL cholesterol during each year (after the fi rst) that
it continues to be taken. The absolute benefi ts of statin therapy depend on an individual’s absolute risk of occlusive
vascular events and the absolute reduction in LDL cholesterol that is achieved. For example, lowering LDL cholesterol
by 2 mmol/L (77 mg/dL) with an eff ective low-cost statin regimen (eg, atorvastatin 40 mg daily, costing about £2 per
month) for 5 years in 10 000 patients would typically prevent major vascular events from occurring in about
1000 patients (ie, 10% absolute benefi t) with pre-existing occlusive vascular disease (secondary prevention) and in
500 patients (ie, 5% absolute benefi t) who are at increased risk but have not yet had a vascular event (primary
prevention). Statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken,
so larger absolute benefi ts would accrue with more prolonged therapy, and these benefi ts persist long term. The only
serious adverse events that have been shown to be caused by long-term statin therapy—ie, adverse eff ects of the
statin—are myopathy (defi ned as muscle pain or weakness combined with large increases in blood concentrations
of creatine kinase), new-onset diabetes mellitus, and, probably, haemorrhagic stroke. Typically, treatment
of 10 000 patients for 5 years with an eff ective regimen (eg, atorvastatin 40 mg daily) would cause about 5 cases of
myopathy (one of which might progress, if the statin therapy is not stopped, to the more severe condition of
rhabdomyolysis), 50–100 new cases of diabetes, and 5–10 haemorrhagic strokes. However, any adverse impact
of these side-eff ects on major vascular events has already been taken into account in the estimates of the absolute
benefi ts. Statin therapy may cause symptomatic adverse events (eg, muscle pain or weakness) in up to about
50–100 patients (ie, 0·5–1·0% absolute harm) per 10 000 treated for 5 years. However, placebo-controlled randomised
trials have shown defi nitively that almost all of the symptomatic adverse events that are attributed to statin therapy in
routine practice are not actually caused by it (ie, they represent misattribution). The large-scale evidence available
from randomised trials also indicates that it is unlikely that large absolute excesses in other serious adverse events
still await discovery. Consequently, any further fi ndings that emerge about the eff ects of statin therapy would not be
expected to alter materially the balance of benefi ts and harms. It is, therefore, of concern that exaggerated claims
about side-eff ect rates with statin therapy may be responsible for its under-use among individuals at increased risk of
cardiovascular events. For, whereas the rare cases of myopathy and any muscle-related symptoms that are attributed
to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if
statin therapy is stopped unnecessarily can be devastating
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